Cerebral Neoplasms

Condition: Cerebral neoplasms, commonly called brain tumors, are abnormal masses of tissue that grow in the brain due to excessive overgrowth of brain cells.

Background: Cerebral neoplasms can be classified as non-cancerous (benign) or cancerous (malignant). These tumors can also be classified as originating in the brain (primary) or originating in another tissue type (metastatic), and metastatic tumors occur more frequently than primary brain tumors. No single underlying cause of brain tumors has been identified. Exposure to ionizing radiation, a suppressed immune system, and environmental toxins have been suggested as potential causes. Cell phone usage is apparently not associated with development of brain tumors.

Risk Factors: Rates of brain tumors are higher in industrialized countries, and men have slightly higher rates than women. Patients with human immunodeficiency virus (HIV), autoimmune conditions, or organ transplants are at increased risk for certain brain cancers (cerebral lymphoma).

History and Symptoms: Symptoms vary and may include increased pressure, headache, nausea or vomiting, personality changes, impaired walking, weakness on one side of the body, visual defects, speech impairment, and seizures. A detailed history will reveal onset, symptoms, and risk factors.

Physical Exam: A physical exam may help determine localization of the brain tumor or other sites of tumors. Neurological examination of mental ability, speech, eye movements, vision, hearing, smell, and balance is essential. Functional analysis is also important to gauge the patient’s mental, physical, pain, and emotional state.

Diagnostic Process: Laboratory tests may offer information about the origin of metastatic brain tumors. MRI is the standard for tumor characterization, which is used for determination of treatment and potential outcomes. PET scans, magnetic resonance spectroscopy (MRS), CT angiography, and electroencephalogram (EEG) may aid in diagnosis.

Rehab Management: Treatment addresses both the effects of the tumor and the side effects of cancer therapies (surgery, chemotherapy, and radiation). A variety of medications are available to improve neurologic function, limit nausea, manage pain, prevent blood clots, and minimize seizures. Rehabilitation focuses on mental challenges such as memory, concentration, and processing speed; communication strategies; emotional issues such as anxiety and depression; quality of life issues; and physical challenges, such as strength, balance, coordination, walking, and fatigue.

Other Resources for Patients and Families: Local and national organizations are available to provide counseling, support, and education for the patient and family. Hospice programs are available to help with end-of-life palliative care.